Ohio State University, Columbus

- Common Variable Immunodeficiency (CVID) is a disorder which lowers the immune systems defenses and makes patients more susceptible to infections in the lungs, sinuses, and ears
- A 53 y/o patient with CVID was admitted with COVID-19
- Patient was already receiving intravenous immunoglobulin (IVIG) for their CVID
- Levels of patient’s immunoglobulin were taken upon arrival and it was noted that their IgG was normal, but IgM and IgA were low and undetectable respectively
- Patient received additional IVIG daily as well as supplemental oxygen in the form of a nasal cannula and then intubation
- Patient was extubated after 3 days and eventually weaned back to room air as well as discharged on day 14 due to clinical improvement
- The paper also noted that there were 2 similar cases of CVID patients receiving supplemental IVIG in Italy who also made a similar recovery
- It was also stated that while testing was not performed for cytokine storm syndrome, 53 y/o did develop some acute respiratory distress syndrome during their treatment

Common Variable Immunodeficiency 

Fill, L., Hadney, L., Graven, K., Persaud, R., & Hostoffer, R. (2020). The clinical observation of a patient with common variable immunodeficiency diagnosed as having coronavirus disease 2019. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 125(1), 112–114. https://doi.org/10.1016/j.anai.2020.04.033

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199724/

The clinical observation of a patient with common variable immunodeficiency diagnosed as having coronavirus disease 2019

CVID and COVID-19 Comobidity Location

- Specific case study detailing the COVID-19 treatment process of a 42 y/o man with CVID, chronic asthma, and severe obesity
- Patient had not received IVIG treatment in 6 months due to insurance complications
- In May patient noted COVID-19 symptoms and received COVID-19 testing, which came back positive
- Was admitted to community hospital with fevers and worsening dyspnea, which revealed multifocal pneumonia
- Patient was intubated and condition worsened, causing patient to be transferred to distant hospital which could provide higher level of care
- When transferred immunoglobulin levels were measured and all Ig levels were extremely low with undetectable IgM
- Patient then received repeat and increasing treatments of IVIG (day 9 was 400 mg/kg to day 17 with 1 g/kg) and condition improved drastically as well as IgG serum concentration increases
- On day 20 patients condition worsened and redeveloped a fever and on day 30 patient suffered cardiac arrest
- It is being hypothesized CVID has the possibility to inhibit antibody development for COVID-19 antibodies in patients due to low levels of serum immunoglobulin

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